Dr. Vineet Kapoor

A beautiful smile plays a very vital role in enhancing the overall beauty of face. Rotated, stained and maL-placed tooth can cause major aesthetic/cosmetic and psychological problems in teenage and young adults. Mid-line teeth gap, rotated teeth, crowded teeth, stained teeth, broken tooth edges and wearing tooth edges are the most common cosmetic problems that our patients report to us. Dynamic advancements in the field of dentistry has come across with the solution of majority of cosmetic problems.

Here we discuss the various options available for improving smile:

1. Veneers: They are thin pieces of porcelain or plastic glued to the front of your teeth. For teeth that are severely discoloured, chipped or misshapen and gaps between the teeth, veneers create a durable and pleasing smile. A veneer is made to match the colour and shape of your tooth. Not everyone is a candidate for professional teeth whitening. Bleaching is not recommended if you have tooth colored fillings, crowns, caps or bonding in your front teeth. There are two types of veneers:

a. Porcelain (indirect) veneers, which must first be created to fit your teeth in a dental laboratory and require two visits to the dentist. Porcelain veneers are generally stronger, while composite veneers are less expensive. With porcelain veneers, the dentist takes an impression of the tooth and sends it to the dental lab for fabrication of the veneer, usually after the front of the tooth has been reduced.

b. Composite (direct) veneers, which are bonded to your tooth enamel in a single visit. With either method, the tooth is prepared for bonding by roughening the front surface with mild etching solution. The veneer can then be bonded to your tooth using a dental bonding cement.

2. Bonding: It uses composite resin to restore chipped or broken teeth, fill in gaps and reshape or recolor your smile. After applying a very mild etching solution that slightly roughens the surface of your teeth and permits the bonding material to adhere, your dentist applies the resin and sculpts, colours and shapes it to provide a pleasing result. A high-intensity light hardens the material, which is then finely polished. Bonding agents are used in treatment of midline gap closures, fractured tooth restoration, wearing teeth edges.

3. Whitening: Some people are born with teeth that are more yellow than others. Others have teeth that yellow with age. Your natural tooth colour can also be affected by many factors. Surface stains (called extrinsic stains by dentists) and discolouration can be caused by:
a. Tobacco (whether smoked or chewed)
b. Drinking tea, coffee, or red wine
c. Eating highly pigmented foods such as cherries and blueberries
d. Accumulation of tartar deposits, which result from plaque that has hardened
e. Treatment with the antibiotic tetracycline during the time when teeth are forming
f. Yellowing or greying of the teeth as part of the aging process
g. Trauma to the teeth that may result in the death of the tooth's nerve, giving the tooth a brown, grey or black colour.

Whitening/Bleaching is a simple procedure where whitening agents are applied over the tooth surface in order to chemically change the colour of tooth. It can either be a single visit clinical procedure or multiple application home procedure under the guidance of your dentist.

Will my newly whitened teeth stain?
Any tooth can stain, including the veneers and bonds mentioned above. To help prevent stains from coming back, avoid smoking, coffee, tea, red wine and heavily coloured foods. And brush your teeth twice a day with a whitening toothpaste. If you wish to discuss about any specific dental problem, you can consult a specilized dentist and ask a free question.

What is it?
Tooth whitening lightens teeth and helps to remove stains and discoloration. Whitening is among the most popular cosmetic dental procedures because it can greatly improve how your teeth look. Most dentists perform tooth whitening. Whitening is not a one time procedure. It will need to be repeated from time to time if you want to maintain the brighter color.

What it is used for?
The outer layer of the tooth is called the enamel. The color of natural teeth is created by the reflection and scattering of light off the enamel, combined with the color of the dentin under it. Your genes affect the thickness and smoothness of the enamel. Thinner enamel allows more of the color of the dentin to show through. Having smoother or rougher enamel also affects the reflection of light and therefore the color.

Every day, a thin coating (pellicle) forms on the enamel and picks up stains. Tooth enamel also contains pores that can hold stains. The most common reasons for teeth to get yellow or stained are:

• Using tobacco
• Drinking dark colored liquids such as coffee, cola, tea and red wine
• Not taking good care of your teeth

Aging makes teeth less bright as the enamel gets thinner and the dentin becomes darker. It is also possible to have stains inside the tooth. These are called intrinsic stains. For example, intrinsic stains can be caused by exposure to too much fluoride as a child while teeth are developing. Other causes include tetracycline antibiotics. They can stain a child's teeth if taken by a mother during the second half of pregnancy or by a child who is 8 years old or younger. Teeth are still developing during these years. Trauma can also darken a tooth and tooth whitening is the most effective way to treat on surface (extrinsic) stains.

More than 5 million teeth are knocked out every year in children and adults. With proper emergency action, a tooth that has been knocked out of its socket can be successfully replanted and last for years. It is important to see a dentist as soon as possible after the tooth is knocked out. Quick action will increase the likelihood of saving the tooth.

Saving a Knocked Out Tooth:
1. Pick up tooth by the crown (the chewing surface) not the root:
Locate the tooth immediately; do not leave it at the site of the accident. The tooth should be handled carefully touch only the crown to minimize injury to the root.

2. If dirty, gently rinse tooth with water:

• Do not use soap or chemicals
• Do not scrub the tooth
• Do not dry the tooth
• Do not wrap it in a tissue or cloth

3. Reposition tooth in socket immediately, if possible:
The sooner the tooth is replaced, the greater the likelihood it will survive. To reinsert, carefully push the tooth into the socket with fingers, or position above the socket and close mouth slowly. Hold the tooth in place with fingers or by gently biting down on it.

4. Keep tooth moist at all times:
The tooth must not be left outside the mouth to dry. If it cannot be replaced in the socket, put it in one of the following:

• Emergency tooth preservation kit
• Milk
• Mouth (next to cheek)
• Regular tap water is not recommended for long term storage because the root surface cells do not tolerate water for long periods of time.

5. See a dentist within 30 minutes:
Bring the tooth to a dentist as soon as possible, ideally, within 30 minutes. However, it is possible to save the tooth even if it has been outside the mouth for an hour or more.